over-downregulating?

[2ndtimeivf]

I had my first round of IVF before Xmas:10 days of Buserelin then added 12 days Gonal- F: 8 eggs retrieved , double transfer but failed. At 7 days of Gonal F my scan showed 15 follicles, they reduced to what we were expecting (7-10 based on AFC) by egg retrieval.

I’m now on my second round of IVF, nothing changed this cycle, other than longer down regulation due to clinic timings. I was on Buserelin 28 days before starting Gonal F. Had day 7 scan today and there are only 4 follicles. They said not to worry, and that some more might grow before next scan but not convinced since last time they decreased.

I’m now worried that my ovaries got over downregulated. Has any one had similar? Or have any advice?

AMH a year ago was 11, AFC 9.

[JA-fnuk Partner Nurse Fertility Network UK]

No 2 cycles of treatment - even on same meds - will be exactly the same Can be entirely different each time . Still plenty of time for follicles to grow and increase in size

Wishing you good luck for the future

Janet-Partner

[2ndtimeivf in reply to JA-fnuk]

Thank you I’m just concerned that last time half dropped off between Day 7 and egg retrieval. There weren’t anymore tiny ones to stimulate.

[JA-fnuk Partner Nurse Fertility Network UK in reply to 2ndtimeivf]

Might be some hiding just waiting to grow

Janet-Partner

[Endofitall]

It does sound like you’ve been down regulated and ovaries over suppressed. Is this NHS funded?

[2ndtimeivf in reply to Endofitall]

That’s what I’m thinking. Nope self-funded but in an NHS hospital.

I asked when they wanted to extend down regulation and the nurse said there’s no evidence that it would cause any harm to the cycle. Even today it said it’s unlikely that over suppression is the cause.

Even at baseline the nurse at first round said she could see plenty of follicles to stimulate, this time when I asked she said she we have to wait until next scan.

Im not sure whether to cancel if there’s no progress on Monday. It’s a massive difference to last cycle, and I don’t want to waste thousands on an egg retrieval if it’s not going to work.

Also I found the day after egg retrieval extremely painful- more so than after surgery for an ectopic, so I don’t want to go through that unnecessarily.

[Endofitall]

I am sorry I’ve recently been in a similar situation (they didn’t do baseline scan and I had a huge lead follicle that turned into cyst with stims and suppressed everything else). I think clinic always seem to want to deny they’re at fault. At my day 8 they wanted me to keep doing stims which I did but then when they said to continue again on day 11 I could see it was going badly so I really questioned them and eventually we made call to cancel. I regret now not demanding baseline and not cancelling on day 8 despite my doubts. We lost so much money in meds but still got a significant refund for cancelling pre collection. It was just too much of a risk for us.

I know people will say different cycles can be different but I’ve had 4 stims with the exact same protocol (plus some others more experimenting with protocol). And when I’ve used this same protocol I respond pretty much identically even sometimes with months/ years apart. So if you’ve got doubts, talk it through, have a look at your folliculograms, and really question the clinic. You often know your case better than anyone else. If one person doesn’t give you a satisfactory answer, ask again to someone else. It’s your money and your body xx

[Pink090]

how long was the gap between ivf treatments as I had egg collection in Nov then even scans in Jan ready for end of Feb FET, showed that my follicles were still collapsing down from previous stims. not sure but thinking would that have anything to do with it? or would the buserlin just collapse them down anyway as part of the down-regulation x

[2ndtimeivf in reply to Pink090]

I’m not sure. I was in Buserelin for a while month. Egg collection was start of December. They said I needed a full cycle. My baseline scan showed my ovaries were all quiet, but by the sound of things too quiet.